Healthcare Provider Details

I. General information

NPI: 1598836041
Provider Name (Legal Business Name): JOY A BUTLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 HUDSON HILLS DR
NEWBURGH NY
12550-1346
US

IV. Provider business mailing address

214 HUDSON HILLS DR
NEWBURGH NY
12550-1346
US

V. Phone/Fax

Practice location:
  • Phone: 845-565-4040
  • Fax:
Mailing address:
  • Phone: 845-565-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR059613
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: